Health insurer DSW suspends payment to general practice Acacialaan of the commercial GP chain Centric Health due to non-delivery of the agreed care.
General practice Acacialaan in Pijnacker (Zuid-Holland) of Centric Health – largely financed by private investors – was recently criticized by the Health and Youth Care Inspectorate (IGJ) for identifying ‘serious shortcomings’ that lead to a major risk to the patient safety’.
It now appears that the preferred health insurer DSW has suspended payment to the general practice because of these abuses. The practice reported on the website – in a message that has since been deleted – that DSW ‘has reclaimed funds’ from Centric Health ‘because they have established that we have not delivered what we promised’. DSW confirms this. ‘To date, Centric Health has shown that it does not meet the conditions for declaring registration fees. For DSW, this is reason to act on this, “said a spokesperson for the health insurer.
Health insurers pay the registration fees for general practices per quarter. This is the amount that the GP receives for all registered patients, regardless of whether those patients come for a consultation. As of April 1, DSW has suspended payment of the registration fee to this Centric Health general practice. For the previous quarter, the payments were recovered for the period in which the care was also not provided. Payment can be resumed as soon as the care provided is satisfactory again.
DSW recently reported that it was looking for solutions to guarantee the continuity of (emergency) general practitioner care for its policyholders
. In a letter to the insured, DSW reports that agreements have now been made with the GP post in Delft. This ‘back guard’ is an emergency solution that patients can turn to if Centric Health’s general practice is not available or accessible. According to DSW, little use has been made of this.